67303 — Cystografin 300ml Bottle/ml
Cite this view
HANK Price Transparency. (n.d.). CYSTOGRAFIN 300ML BOTTLE/ML (HCPCS 67303) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/67303?code_type=HCPCS
“CYSTOGRAFIN 300ML BOTTLE/ML (HCPCS 67303) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/67303?code_type=HCPCS. Accessed .
“CYSTOGRAFIN 300ML BOTTLE/ML (HCPCS 67303) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/67303?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $0–$12,191 (25th–75th percentile) across 3 hospitals · 21 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 67303 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| ACMH HOSPITAL Outpatient | Geisinger Medicare | Geisinger Medicare | $0.07 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicaid | Geisinger Medicaid | $0.07 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicare | Geisinger Medicare | $0.07 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicaid | $0.07 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicaid | $0.07 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicaid | Geisinger Medicaid | $0.07 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Chip | Upmc Chip | $0.09 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Health And Wellness Commercial | Pa Health And Wellness Commercial | $0.09 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Chip | Upmc Chip | $0.09 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc | $0.09 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Medicaid | United Medicaid | $0.09 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Health And Wellness Commercial | Pa Health And Wellness Commercial | $0.09 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Medicaid | United Medicaid | $0.09 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc | $0.09 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger | Geisinger | $0.10 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | The Health Plan Commercial | The Health Plan Commercial | $0.10 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | The Health Plan Commercial | The Health Plan Commercial | $0.10 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger | Geisinger | $0.10 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United | $0.13 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United | $0.13 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Chip | United Chip | $0.80 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | United Chip | United Chip | $0.80 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Carelon/Beacon Beahvioral Health | Carelon/Beacon Behavioral Health | $2.00 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Carelon/Beacon Beahvioral Health | Carelon/Beacon Behavioral Health | $2.00 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Cigna | Cigna | $2.16 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Cigna | Cigna | $2.16 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Multiplan | Multiplan | $3.60 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Multiplan | Multiplan | $3.60 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Multiplan | Multiplan | $3.60 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Multiplan | Multiplan | $3.60 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Workers' Compensation | Pa Workers Compensation | $4.00 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Snf Episodic Bundle | $4.00 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Tricare | Tricare | $4.00 | $4.00 | $1.20 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Snf Episodic Bundle | $4.00 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Tricare | Tricare | $4.00 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Workers' Compensation | Pa Workers Compensation | $4.00 | $4.00 | $1.20 | 2026-05-23 | MRF ↗ |
| DENVER HEALTH & HOSPITAL AUTHORITY OutpatientFacility | United Healthcare | HMO/POS/PPO | $4,344.00 | — | — | 2026-04-30 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | NEBRASKA TOTAL CARE | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | LAW ENFORCEMENT | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | HEALTHY BLUE | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | UHC COMMUNITY PLAN NE | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | LAW ENFORCEMENT | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | HEALTHY BLUE | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | UHC COMMUNITY PLAN NE | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL OutpatientFacility | NEBRASKA TOTAL CARE | MANAGED MEDICAID | $12,190.88 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | BLUE CROSS | PPO | $22,271.80 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | BLUE CROSS | PPO | $22,271.80 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | AETNA | PPO | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | NE WORKERS COMP | NE WORKERS COMP | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | UHC | PPO | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | AETNA | PPO | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | MIDLANDS CHOICE | PPO | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | MIDLANDS CHOICE | PPO | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | UHC | PPO | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |
| COMMUNITY HOSPITAL BothFacility | NE WORKERS COMP | NE WORKERS COMP | $22,506.24 | $23,444.00 | $21,099.60 | 2025-12-27 | MRF ↗ |